Evaluating the implementation of a quality improvement initiative: weekend gastrojejunostomy tube maintenance service in a tertiary pediatric center.

INTRODUCTION BACKGROUND: • Children unable to feed safely and adequately by mouth may be fed via a gastrostomy tube (G) • Children with associated severe gastroesophageal reflux may be fed via a gastrojejunostomy (GJ) tube. • Many children fed via GJ tubes have multiple complex co-morbidities – medically fragile group of children • GJ tubes require intermittent maintenance procedures (tube checks, changes, reinsertions) • Most GJ maintenance procedures require fluoroscopy & a return visit to hospital (mean 1.2-1.7 times/year) • GJ Tube maintenance procedures are usually not considered an emergency